Low back pain is rarely about one bad moment, it’s usually the moment a pattern finally caught up with you. Finding that pattern is the difference between temporary relief and actually fixing it.
What’s Actually Driving the Pain
The lumbar spine and hips share the workload of nearly everything you do standing, sitting, and bending. When one side of that partnership stops pulling its weight, usually the hips, the low back ends up absorbing more than it’s built for.
Sitting Is the Usual Suspect
Long stretches in a chair shorten the hip flexors and deactivate the glutes, the two muscle groups that are supposed to stabilize the pelvis. Once that support weakens, the lumbar spine picks up the slack, and it doesn’t take much, a wrong twist, an awkward lift, to trigger pain in a spine that’s already overworked.
After an Accident or Injury
A car accident or a specific lifting injury can strain the lumbar discs and joints directly, sometimes causing pain that radiates into the hip or leg if a nerve root gets irritated. This pattern usually needs a different starting point than a slow-building postural issue, since there’s often acute inflammation to address first.
Deconditioning Over Time
For patients who’ve gradually become less active, whether from a previous injury, a desk job, or just less movement in daily life, the core and hip muscles that protect the low back can lose enough strength that even normal activities start causing strain.
How Dr. Devine Evaluates Low Back Pain
The exam looks at the lumbar spine, pelvis, and hips together, since treating the low back in isolation usually misses whatever’s actually driving the problem. That includes checking hip mobility, testing core stability, and assessing whether pain is mechanical (movement-related) or has a nerve component that changes the approach entirely.
When Nerve Involvement Changes the Plan
If pain radiates into the leg, or there’s numbness or tingling, that points toward nerve root irritation rather than a purely muscular issue. Dr. Devine will test for this specifically, since it usually calls for a different pace and technique than a straightforward muscular strain.
Treatment Built Around the Full Kinetic Chain
Adjustments to the lumbar spine, pelvis, and SI joint are typically part of the plan, aimed at restoring mechanics that have been compensating for months or years. Alongside that, spine-sparing movement coaching, how to bend, lift, and sit without re-loading the same problem area, tends to matter as much as the adjustment itself for keeping results.
Building Back the Support System
Once acute pain settles, the focus shifts to core and hip strength, since a spine that’s finally moving well still needs the surrounding muscles doing their share of the work, or the same pattern tends to return.
Frequently Asked Questions
Should I rest or stay active?
Complete bed rest usually isn’t helpful beyond the first day or two. Gentle movement, guided by what the exam finds, generally supports recovery better than prolonged inactivity, though the specifics depend on what’s actually going on.
I have pain running down my leg, is that normal?
It can indicate nerve involvement, which is worth evaluating directly rather than waiting out. It doesn’t necessarily mean anything serious, but it does change what the treatment plan should prioritize early on.
How is this different from just stretching it out myself?
Stretching can help temporarily, but if the underlying restriction, whether in the spine, hip, or both, isn’t addressed, the same tightness tends to return. The evaluation is what identifies which specific area needs the actual correction.